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On histopathology, the tumors were composed of 

cancerous nodules growing with a ‘‘targetoid appear-

ance’’ in which tumor cells are arranged around ducts

and lobules in a concentric fashion, which looks like

the periductal growth of fibroadenoma. Fibrous bands

were compressed between the nodules (Fig. 1b) andcorresponded to nonenhancing internal septa on MRI.

Slender strands of cells arranged in a linear fashion,

the major characteristic growth pattern of ILC, were

not dominant in our cases.

The most common features of ILC on MRI are an

irregular ⁄  spiculated inhomogeneous mass with or

without enhancing surrounding small foci, multiple

small enhancing foci with interconnecting enhancing

strands, and architectural distortion; however, the MR

appearances of our cases well reflected one of the

intrinsic growth patterns of ILC. Although nonenhanc-

ing septation is one of the diagnostic features of fibroadenoma, we should notice that ILC can demon-

strate nonenhancing septa on MRI.

Apocrine Carcinoma of theBreast: Clinical,Radiologic, and Pathologic

Correlation

Ethem Unal, MD,* Aysun Firat, MD,†

Pembegul Gunes, MD,* GamzeKilicoglu, MD,*Ahmet Gulkilik, MD,†

and Izzet Titiz, MD*

*Departments of General Surgery, Pathology,and Radiology, Haydarpasa Numune Researchand Training Hospital, Haydarpasa;†Department of Obstetrics and Gynecology,Bakirkoy Maternity and Childrens Educational Hospital, Istanbul, Turkey

(a) (b)

Figure 1. (a and b) A retroareolar high-density mass, 1 cm in diameter, with speculated margin. Several heterogenous macrocalcifications

can also be seen in the mass.

Address correspondence and reprint requests to: Ethem Unal, MD, 597

Grand Avenue, # 4c, New York, NY 11238, USA, or e-mail: ethemunal@

hotmail.com.

ª 2007, Copyright the AuthorsJournal compilation ª 2007 Blackwell Publishing, Inc., 1075-122X/07 The Breast Journal, Volume 13 Number 6, 2007 616–623

Apocrine Carcinoma of the Breast  • 617

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Apocrine carcinoma is a rare, unique, and morpho-

logically distinct type of invasive breast carcin-

oma. This report is of apocrine carcinoma of the

breast arising in a 78-year-old female presenting with

right areolar retraction and palpable axillary lymph-

adenopathy. Mammography was obtained, and itshowed a retroareolar high-density mass, 1 cm in

diameter, with speculated margin (Fig. 1a, b). There

were also several heterogenous macrocalcifications in

the mass. Corresponding sonography revealed hypo-

echoic mass with posterior shadows. A fine needle

aspirate of the subareolar mass showed clusters of 

atypical cells that were enlarged and showed nuclear

atypia, prominent nucleoli, and cytoplasmic granules

(Fig. 2). Papillary cohesive clusters of ductal cells with

apocrine change were also identified. The fine needleaspiration diagnosis was apocrine carcinoma. The

patient underwent modified radical mastectomy. His-

tologic examination of the excised specimens showed

extensive, solid apocrine carcinoma with focal stromal

invasion (Fig. 3). Apocrine carcinoma of the breast is

typically, although not always, positive for gross cystic

disease fluid protein-15 (GCDFP-15). Compared with

nonapocrine carcinoma, apocrine carcinoma is charac-

terized by less positive rates of estrogen receptor (ER)

and progesterone receptor (PR), and by frequent rates

of unilateral multicentric breast carcinoma with signifi-

cant difference. These features were also well-correlatedwith our findings in the present case (GCDFP15+, ER),

and PR)).

Clear Cell Malignant

Myoepithelioma—BreastPresenting as a FungatingMass

Shramana Mandal, MD, DNB, KajalDhingra, MD, Somak Roy, MBBS,Vijay Saroha, MBBS, and NitaKhurana, MD

Department of Pathology, Maulana Azad Medical College, New Delhi-110002, India

A 45-year-old female presented with a fungating

mass in upper central quadrant of the right breast

Figure 3. Histologic examination of the excised specimens

showed extensive, solid apocrine carcinoma with focal stromal

invasion (H&E, ·200).

Figure 2. A fine needle aspirate showing clusters of atypical

enlarged cells. Nuclear atypia, prominent nucleoli, and cytoplasmicgranules are seen in the clusters of ductal cells with apocrine

change (H&E, ·200).

Address correspondence and reprint request to: Nita Khurana, Maulana

Azad Medical College, New Delhi-110002, India, or e-mail: nitakhurana@

rediffmail.com.

ª 2007 Blackwell Publishing, Inc., 1075-122X/07 The Breast Journal, Volume 13 Number 6, 2007 616–623

618 • mandal et al.